Unspoken

The leeches are being applied to his flap repair as weenter.We were not able to save his tongueand the partial closure oozes blood from chin to navel.Yet, despite the swelling and the recently re-created lips,we discern a smileand he scrawls on the whiteboard:“Good morning! How are you today?”

An Explosive Situation

Veteran with a bushy white beardDinosaur-feet slippers in his roomA raspy voice, always looking downHis bird, Angel, and unbelievable storiesDiuresisDischargeThe smell of smokePatient looking down, char behind earMischievous grinAn explosive situationENT to the ORMakeover of charred beard, brows and mustacheBack home to Angel

Trauma Level 1 Activation

Driver dead on arrivalPassengerC collar in place, fingers tremblingSpeaking on the phoneMother sayingHe didn’t make itPassengerSobbing, squeezing my handSayingIt’s my faultIs he really deadPassenger17 years oldSpine and pelvis brokenWailing, screaming, shiveringI get a warm blanketSayingIt’s not your fault

Court-Ordered Lorazepam

“How are you today?”Standing. Fidgets with her feeding tube.Stares at nothing.“Um.”Another eternity. Another “um.”Finally: “I don’t need to be here.”But her chart tells another story.Court-ordered lorazepam. ECT.Nightmares inflicted.A success, I hear later.Does she resent her jailors?Does she remembertheir superhuman patience?Her 50-minute showers?

99 Dead in Airstrikes on Gaza Today

Count backwards from 99struggle to stay awakeRattle and shakeAgainst propofolExcuses for where the missiles fallCareful the slogans you useAnd the patients you chooseTo advocate for.Forget what you swore.Some harm is fineIf they’ve committed the crimeOf being born on the wrong side of the fence.

One Liner

Our patient is a shy but secretly silly 6 year old girl with ahistory of remarkable PlayDough sculpting skills and alove of turtles, who presented shortly before joining swimteam for the first time. She is accompanied by parentswho are still grieving the loss of another child and rarelyleave her side.

Gravida

A mother’s fourth babyMy first to help deliverIt’s a successI walk out elatedBeaming While sharing the joyWith a fellow classmateI’m interruptedBy a resident rushingTo be embracedBy another colleaguePushing words through tearsA baby did not make itJust next door to the mother of four

SB 16

Gender dysphoriaEvery minuteIn every mirrorSo they tried to end itTwice 11 years oldIn the adolescent unit“High Suicide Risk” On the long waitlistHoping forPuberty blockersUntil SB 16 On the West sideWith a single momFour siblingsCannot afford to travel Affirming careImpossibleIllegal Now what

Memento Mori

You are entering the medical record of a deceasedpatient.Are you sure you want to proceed?Click OKDid you know we gray-out the patient photo?When you publish this chart reviewAnd you tack first author to your nameWe will stand behind you at your TriumphAnd whisper into your ear:Remember…

Same Barber

I started losing hair when I was 17.Ten years, a thousand doses of minoxidiland a single moment of acceptance with a razor in handlater,I walk in, bald, with a pamphlet on alopecia areataas you stare at the floor with tear-stained cheeks.You look up at me and grin,“Nice haircut.”

Puzzle Incomplete

Trauma shiftHeart transplant patientConsult for bowel ischemiaNo need for surgeryContinued rise in lactateBack and forth to the ICUFamily in waiting roomPuzzle scattered on tableWashout of chestOR brought to ICUIrreversible damageWife hugged and thanked meNew life lost to the nightTears streamPuzzle incomplete

Morbid

By definition, an adjective.Relating to disease;Gruesome or grisly A patientBy definition, a BMI of 45“Morbidly obese”Not a surgical candidate“Too high risk”Comments between providers“Weight loss needed”Dismissed by doctors in clinicOn roundsNot identified by their nameRather, by theirBMI of 45Is that notMorbid

The Price of Breath

Everything is ready to go.The orders are in, the discharge papers are signed.The comforts from home packed up away into hospitalbags.But we waitWe wait for the insurance companyFor their seal of approvalSo that my patient can go home with oxygenThe price we payThe price to breathe.

Imperceptible Growth

Med student’s journey, a script of mishaps,Pimp questions stumbled, like a maze without maps.Patient plans faltered, never totally right,Feeling lost in the script, chasing knowledge’s light. A year’s evolution, a metamorphose,From doubt’s shadows, some wisdom arose.An unconscious ascent, not realizing you grew,Now new students ponder, how to emulate you.

Lives Changed Through Loss

Arteriovenous malformation in the brain.The sword of Damocles fell suddenly.Now a vibrant youthful son was a comatose organ home.Liver, heart, lungs, kidneys, skin, corneas.A tear ran down the attending’s cheek as the family wept.No time, hurry to the Operating Room.One life ended.Renewed life for a half dozen more.

Fruit Snacks

My team’s running across the hospital to respond to acode.What is my role?“Do you know how to do compressions?”“I think so.”I hear “push deeper,” as ribs are breaking underneath myhands.We call it. Tired and sweaty, we resume rounding.Someone throws me fruit snacks.“For the adrenaline,” they say.

Apathy Confirmed

MS4.ERAS submitted.Apathy.Advanced IM.Intense attending.Outrageous pimping.Team bonding under tyranny.Sunday, high hopes for early exit.Chill senior gives green light.Enjoying afternoon.Phone rings.Attending calling.“Hello”“Aren’t you supposed to be here?!”“Senior said I could leave.”“Come back for a paracentesis?”“No, I’m good.”“Really?”“Yep…”Apathy confirmed.

Ode to the Cool Resident

To the resident who insists on sunshine and coffee breaks,Who plays medical charades behind your attending’s backwhile they pimp you on rounds,Who credits you with their thoughts,Who sends you home early,Who unmasks hidden curriculum,We appreciate you,We love you,We idolize you,And may we become you someday soon.

Voices

Voices on the wardsFalling silentA commitment to do no harmBut trapped in the webs of hierarchyToo afraid to fallToo afraid to failTo speak Voices amongst friendsSpeaking upSharingSayingIt will be different one dayOnce I am a residentOnce I am a doctorBut will it

The Nice Skunk

She had been assigned to PICU RED.That was my team.A shunt was to be placed,to remove the pressure from her brain.Her long-term prognosis?A short-term lifespan.Palliative neurosurgery.My attending pulls me aside—he empowers me to sit this one out.The patient is my best friend’s daughter.My twin.Jane1.

Wind

You sang with your brothers,louder than the harsh fan swirling hot hospital air andgriefthrough my hair, across your body and graying beard.Eyes bright like starlight. I wasn’t ready, but you wereTo go with the wind, as you said. “It was good to see you.”“It was good to be seen.”

Salty Rain

It was a rainy dayAnd through the skylights in the pediatric ICUI felt salty rain hitting my cheeks A little girl was dying.Her family hugging her edematous bodyThat had once run, jumped, and played There were no other options, the medical team saidAs if we were talking about the rain

Begin Again

I know what I wantI want the patients to feelSome semblance of neutral“Healthy” being the motionless nodesAlong that sinusoidal waveWith its own peaks and troughsOf pain, of anxiety, of uncertaintyAndOf relief, of hope, of healingLet us give them that equilibriumSo that they can begin again

Now and at the Hour of Our Death

“Hail Mary full of grace,” the opening to a prayer that Ihad said many times throughout my life.I seldom pray in the hospital, but I also seldom satholding my mother’s hand while she was in a coma in theICU. I finished my prayer, said, “Amen,” and startedagain from the beginning.